Active NPI
Alwyn Frederick Solomon, DMD
- Public Health Dentistry
- Summerville, SC
National Provider Identifier
1992862742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- SC2301
- Practice address
- 1971 N Main Street
Summerville, SC 29483 - Phone
- (843) 871-0842
- Fax
- (843) 832-4531
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | SC2301 | SC | Primary |
Addresses
Primary practice location
1971 N Main Street
Summerville, SC 29483
Mailing address
1971 N Main Street
Summerville, SC 29483
Phone (843) 871-0842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 409001 | Medicaid | SC |
Other names 1
- Dr. A Frederick Solomon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160614001646 | SC | Order and Referring Only - Oral Surgery | 0648561100 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC2301 | SC | MD | Public Health Dentist |
| 2301 | SC | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SFD Carnes LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Summerville, SC
- NPI 1144762576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439856000000",
"number": "1992862742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1971 N MAIN STREET",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "29483",
"telephone_number": "843-871-0842",
"fax_number": "843-832-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1971 N MAIN STREET",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "29483",
"telephone_number": "843-871-0842",
"fax_number": "843-832-4531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "ALWYN",
"middle_name": "FREDERICK",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2015-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "SC",
"license": "SC2301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "409001",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "A",
"last_name": "SOLOMON",
"middle_name": "FREDERICK",
"prefix": "DR.",
"credential": "DMD",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.